CHAMPioning Reverse Integration Model in a Community Mental Health Center

Caitlin Mulligan (1,2), Niharika Brungi (1), Liana Raberg (1), Sarah Maclaurin (1,2)

1. Freedom Trail Clinic of North Suffolk Community Services
2. Massachusetts General Hospital, Department of Psychiatry

Abstract

Background: Outpatient mental health (MH) clinics are often the primary and most consistent point of contact with medical providers for underserved populations like those with Serious Mental Illness (SMI) and patients experiencing homelessness. People with SMI on average die up to 25 years earlier than the general population due to medical co-morbidity and limited access to preventative medical care1. The relationship between mental health and medical conditions are often bidirectional, therefore, addressing both conditions is crucial for improving a person’s overall quality of life and well-being.
Methods: Between April 2022 and March 2023, 140 patients met with a registered nurse or nurse practitioner to complete Comprehensive Health Assessment and Medical Prevention Screening (CHAMPS), an assessment that covers a wide range of preventative health and mental health screenings. Obtaining these results created an opportunity for cross-disciplinary collaboration with primary/specialty care, thus improving care coordination, patient education and access to care.
Results: 90 individuals (65%) were current or former smokers and 29 (51.72%) of those eligible completed lung cancer screening. 45 individuals had completed screening for colorectal cancer at the time of the assessment and of those remaining who were eligible, an additional 29 (93.10%) completed with assistance. 28 individuals completed breast cancer screening and 5 individuals completed prostate cancer screening with an additional 6 after the assessment. 128 individuals had primary care physicians and 32 appointments were scheduled for follow up at the time of assessment.
Conclusions: Reverse Med-Psych Integration in an outpatient community mental health clinic for underserved populations is feasible and effective. Addressing mental health concerns alongside medical conditions improves adherence to recommended treatment plans and improves overall health. This can result in reduced hospitalizations, emergency room visits, and better long-term health outcomes.